title: Monitoring the impact of the electronic medical record on the quality of laboratory test ordering practices.
abstract: The aim of this study was to examine the impact of the Electronic Medical Record (EMR) on the quality of laboratory test orders made by clinicians. The study assessed the type and frequency of pre-analytical laboratory test order errors that were associated with the EMR across three hospitals and one pathology service. This involved a retrospective audit of the laboratory error logs for the period 1 March 2010 to 9 October 2011. Test order problems associated with the EMR occurred at a total rate of 1.34 per 1000 test order episodes across the three hospitals. In the majority of cases these errors were caused by the inappropriate use of the EMR system by clinicians. The errors resulted in increased data entry time for laboratory staff in the Central Specimen Reception area and led to a median increase of 181 minutes in test turnaround times for those test orders. The study highlights the importance of monitoring and comparing the impact of EMR systems in different locations over time in order to identify (and act upon) factors that can adversely impact on the effectiveness of pathology laboratory processes.
authors.affiliation: Centre for Health Systems & Safety Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Georgiou
authors.forename: Elia
authors.initials: E
authors.lastname: Vecellio
authors.forename: George
authors.initials: G
authors.lastname: Toouli
authors.forename: Alex
authors.initials: A
authors.lastname: Eigenstetter
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Roger
authors.initials: R
authors.lastname: Wilson
authors.forename: Johanna I
authors.initials: JI
authors.lastname: Westbrook
mesh_terms: D003955:Diagnostic Tests, Routine; D057286:Electronic Health Records; D006801:Humans; D050316:Medical Order Entry Systems; D010818:Practice Patterns, Physicians' / Q000592:standards*; D017064:Process Assessment, Health Care